
Sports have become serious business. Not just for college athletes and pros, but for young people who haven’t even stopped growing.
Distinct sports seasons have been replaced by year-round participation. The idea of cross training or playing several sports has been replaced by single-sport aficionados who are too young to realize their bodies might be better suited to play a sport they hadn’t considered.
There is too much riding on sports participation for some youth, say the physicians and therapists who attend to the injuries. And these young bodies, and sometimes spirits, are paying for it.
Dr. Brian Bixler of Orthopedic & Spine Specialists of York deals with these issues every day. One of Bixler’s patients was a girl who played soccer and basketball. By the time this teen was in the ninth grade, Bixler had reconstructed the anterior cruciate ligament, known as the ACL, in each of her knees.
Having ACL surgery changes a knee forever, says Bixler. “You can get back to play, but it is not stable,” says Bixler.
In some cases, a sports injury can result in a lifelong problem. For example, says Dr. Matthew J. Kelly of Orthopedic Institute of Pennsylvania, which has offices in Camp Hill, Harrisburg and Hershey, if a bone is broken in its growth plate, it “could stop growing prematurely or grow with an angle.”
Many injuries can lead to arthritis, says Kelly, and concussions suffered in youth can potentially lead to problems later in life.
Dr. Gregory Hanks, Kelly’s colleague at Orthopedic Institute of Pennsylvania, says it isn’t possible to completely prevent injury, but he suggests that parents make sure their teens are involved in preseason conditioning, stretching and strength training to help reduce injuries.
Year-round sports can lead to overuse injuries, says Hanks. “It’s better to do something different in your off season, [such as] an alternate sport or other training.”
Hanks has seen kids burn out on a sport. “After doing it year-round, they don’t have the passion to play,” he says.
In some cases, a sports injury can result in a lifelong problem
Young kids should explore multiple activities, Hanks says. “They might turn out to be a better player of field hockey than soccer when they get older,” he says.
Bixler of Orthopedic & Spine Specialists agrees. “You need an off season. You need to set aside time to not do exactly what you’ve been doing,” he says. During that time, Bixler says, the young athlete can do strengthening and conditioning.
Hanks thinks kids are pushed too much. “In reality, there are few that make it on a college or professional level,” he says.
Competition starts young for a college scholarship, says Bixler, which could potentially be worth about $250,000. “People start very young with single-sport, year-round competition and put themselves at risk for injures we would never consider years ago,” he says.
Bixler has seen some kids who play on three simultaneous teams. “They will play four or five baseball games a day.”
Some of these kids end up with what is called a “Tommy John” injury, named for a baseball player, which is an injury to the main ligament in the elbow. It used to be that patients in their late 20s or 30s would have this injury, says Bixler. “Now, we are seeing teenagers, 14 or 15 years old, requiring Tommy John surgery,” he says.
Hannah Martin, 14, who plays soccer at Lancaster County Christian School, is lucky because she was been able to reverse, without surgery, the cause of the pain that sidelined her.
Hannah stopped playing when her knee pain became so bad she was limping and having trouble going up and down stairs. After having physical therapy with Dawn Cox, owner of Prana Functional Manual Therapy in Lancaster, Hannah and her mother, Monica, were amazed after just one session.
Cox saw that Hannah was pronating, or turning her foot inward, says Monica. After Cox massaged the tightened muscles on the inside of the foot, Hannah stood up, and her foot no longer turned inward, says Monica.
Gradually, Hannah began strengthening her back muscles, hamstrings, quadriceps and core through physical therapy, says Monica. She has learned better posture. “We consider the whole situation a gift from God. Because of [Hannah’s knee problem], in the long term she can be spared further injury,” says Monica.
Cox sees a lot of young dancers and athletes after they are injured or begin to have pain. But she asks, “Why aren’t we looking at them before they have an injury?”
Her goal is to team with coaches and trainers to help prevent injuries. She would like to be able to teach young athletes the “baby steps” they should learn before moving into the higher skills of their sports.
First, they should be learning “how to stand, how to walk, how to sleep.”
“They are so uncoordinated in the trunk,” she says. “They don’t even know how to stand,” let alone run or kick.
In their everyday life, young people are engaging in habits that weaken them, such as slouching when standing and sitting, says Cox, but then are expected to perform in sports with a stable core and strong muscles.
“Twenty minutes of conditioning can’t override what they do all day,” she says.
Just as Cox isn’t shy about her promotion of young athletes learning how to hold their bodies and strengthen their cores, Bixler isn’t shy about his opposition to year-round sports.
Just ask his wife, his daughter and the coach of the club team his daughter plays on.
Bixler tried to get the coach to agree to breaks, but his wife and the coach said the girls would fall behind if they didn’t train and play seven days a week.
“My daughter missed five months with a shoulder injury,” he says, and was not able to play when recruiters from colleges were visiting.
“She violated all things I’m telling you, but she is paying for it. Now she has to change what schools she can look at,” he says.
“Fortunately she’s better now,” he says, but she’s also involved in strength training and has improved her nutrition.
“She has seen my wisdom,” says Bixler.
How To Evaluate a Sports Program & Coaches
Look for published safety procedures and ensure they are followed
Make sure the program works with a certified athletic trainer
Seek out coaches who encourage proper nutrition, sleep and strength training, and stress that not just games are important
Look for coaches who understand what a child’s body can and cannot take and know the latest theories of preparation